Individual
GRACE VANTHUYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
1241 ANDERS RD, LANSDALE, PA 19446-4816
(267) 844-1356
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA066996
PA
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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